Doctors in PA recommendations

I was just at a visit with my rheumy that was unnecessary. I had already done by follow up and had to come back within a few weeks because he insisted on checking my joints again. He had nothing to say when I went to this appointment and asked why I was there! I am in pain constantly and am in need of a medicine to go along with my Humira to treat this pain. He said that I have no swelling in my joints but they hurt constantly and I am up all night crying because of how badly it hurts and am miserable some days. I am in college and find it very difficult to function like this. Someone on here recommended I see a pain specialist to treat the pain since my rheumy won't give me anything besides an anti inflammatory which doesn't help. Does anyone know of any good pain specialists in Pa? It can be near Monroeville or Pittsburgh, or anywhere near those areas. I have UPMC insurance. Thanks

You will need a referral from either your PCP or Rheumy to get into pain management. I'd start there. There are not a lot of conditions helped by pain meds treated by Rheumatolgists and a few made worse which is why you will need a referral. Undiagnosed pain is hard to get treated and getting harder. They have learned the narcos makes it worse and more permanent.

Apparently your Rheumy has a plan, maybe he should let you in on it????? It may be time to consider a change in NSAIDS, or something else. He apparently is monitoring a few things.

Eh, I do not agree with mataribot at all. In fact, I'd say his suggestion is not only foolish, but criminal. Shopping around for pain meds is a good way to get flagged and arrested. Not sure what "other" drugs he is referring to but remember it is extremely dangerous to take "other" meds NOT rx'ed by your physician.

My suggestion would be this. Ask your doctors about trying another biological medicine. If your taking Humira and are still in this much pain then I'd say the results are not at all optimal. Perhaps one of the other heavy hitters will do the trick. Humira did nothing for me, but Enbrel works like a charm.

All I was suggesting was saving your unused subscriptions for a rainy day. I don’t know any doctor that will simply subscribe pain killers for no good reason. Most doctors receive information on what medications you picked up at your local pharmacy, so it’s increasing difficult to “kite” doctors for pain medication. Now I did not come up with the idea to save my medication I don’t immediately use, My DOCTOR suggested it. All my medication I save is related to my condition, and I have every right to save it for when I need it. All my doctors are informed on when and what medication I use.

Now back to the subject - getting a referral to a pain specialist for PsA can be difficult. There are other things such as steroids that wi give you relief, but those can cause rebound flares and typical harsh on hour blood sugar.

The number one reason biologics fail is because patients do not see immediate results. It takes at least 4 - 6 weeks to see full results for Humira. I would suggest giving it at least that long before trying another biologic.

I have been on humira for a year already. I tried steroids and it caused a major flare in my psoriasis and doctor isn’t helping much with finding another treatment plan

Have you asked for the referral like tntlamb suggested?

It can be difficult to get your doctor to listen when you don’t have much swelling. However, that does not mean your disease is not active. There are other biologics out there besides Humira that are approve for either or both RA and PsA.

I think you need to convince your Rhumy that your disease is active and try other treatments or seek another Rhumy if they are not listening. I am going to have to agree with tntlamb - pain meds is not the path to take. If you your disease is not under control you risk un reversible damage to your joints. Use the pain meds for the days you absolutely need them. Maybe set an appointment with your GP and see what he thinks. He maybe willing to get you some temporary meds for the time being.

The problem is my gp didn’t believe I had arthritis at all! I’m only 19 so they don’t take me seriously. I need new doctors I guess.

Hi Megan Marie,
First I think you’re a champ for dealing with this at 19. Second, I wonder if it would help you to have someone help advocate for you. At 19 with such a debilitating disease that is misunderstood outside the rheumatology specialization (and sometimes even within it) it might be time for you to bring some reinforcements to your appointments. I don’t know whether this could be a family member, but my take is that if you had an older adult with you, you may get some traction.

I know a lot of people on this site take very careful notes with them to their appointments. They track their swelling, pain, psoriasis, and so on, and they talk their physician through their symptoms. This might be a way to demonstrate the extent of your pain to your rheumy.

It isn’t fair that you’re not being believed by professionals but I do think there’s so much fear about overprescribing pain meds that some doctors might not take you seriously. Further, I don’t think it’s fair that you might need reinforcements in the doctor’s office to make your case, but if it gets you the outcome that’s right for you, go for it.

Good luck!

If they didn't believe you, they would be a lot more liklry to give you a bottle of T-3 and send you on your way than 30 grand worth of Humira........... Somehow you are either missing something or there needs to be some communication. Most folks are lucky to see a Rheumy a couple time a year let alone every two eeeks.